Basic Pharmacology for Nurses 17th Ed by Clayton - Willihnganz
Basic Pharmacology for Nurses 17th Ed by Clayton - Willihnganz
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Chapter 10: Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | “Insulin injection sites should always be in the abdomen to ensure absorption into the stomach.” |
| b. | “It is important to rotate injection sites systematically within one area before progressing to a new site for injection.” |
| c. | “Following exercise, site rotation is not indicated because the circulation in the muscles will absorb the medication efficiently.” |
| d. | “If you aspirate, site rotation can be done every other day to avoid developing problems with absorption.” |
ANS: B
The American Diabetes Association Clinical Practice recommendations include rotating injections systematically at one site before progressing to another. Insulin is not absorbed into the stomach. Failure to rotate sites can result in lipohypertrophy or lipoatrophy. When subcutaneous (subcut) insulin is administered, aspiration should never be performed.
DIF: Cognitive Level: Application REF: Page 132 OBJ: 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education
| a. | Aspirate before injecting the medication. |
| b. | Inject at a 45-degree angle. |
| c. | Inject at a 90-degree angle. |
| d. | Massage site following injection. |
ANS: B
For thin individuals, the skin may need to be pinched and a 45-degree angle used to avoid administration into the muscle. Heparin should never be aspirated. Subcut injections are properly administered at a 45-degree angle. The injection site of heparin should never be massaged.
DIF: Cognitive Level: Application REF: Page 136 OBJ: 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Development
| a. | Rectus femoris |
| b. | Dorsogluteal |
| c. | Deltoid |
| d. | Ventrogluteal |
ANS: C
The deltoid muscle is often used because of its easy access and the fact that it can tolerate 0.5 mL of medication volume. Having the child disrobe is not efficient in this setting.
DIF: Cognitive Level: Application REF: Page 138 | Page 139
OBJ: 5 TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Development
| a. | 5/8 inch, 25-gauge needle with 5 mL syringe |
| b. | 1 inch, 28-gauge needle with 4 mL syringe |
| c. | 1 inch, 21-gauge needle with 3 mL syringe |
| d. | 3 inch, 16-gauge needle with 1.5 mL syringe |
ANS: C
It is important to correlate the syringe size to the size of the patient and the tissue mass. The usual amount injected intramuscularly is 0.5 to 2 mL. Needle lengths commonly used for adults are 1 to 1 inches long. A longer needle may be used for a significantly obese adult. Commonly used needle gauges for IM injections are 20 to 22 gauge. A 5/8 inch, 25-gauge needle is too short and too small to administer a viscous medication. A 1 inch, 28-gauge needle is too small to administer a viscous medication. A 3 inch, 16-gauge needle is too large and too long to administer medication to a patient this size.
DIF: Cognitive Level: Application REF: Page 136 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety
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